Dr Kaye Explains: HIV and AIDS

World Aids Day is on December 1^st every year, while many people recognise the red ribbon is worn to raise awareness of HIV and support for people living with HIV, what do you know about HIV and AIDS?

What is the difference between HIV and AIDS?

The first thing to be aware of is that HIV and AIDS are not the same thing. HIV stands for Human Immunodeficiency Virus which is a viral infection, which affects the immune system over time. AIDS, which stands for, acquired immune deficiency syndrome, may occur years after infection with HIV, when the immune system has become damaged and can’t fight off infections and other diseases. HIV can be transmitted between people, but you cannot spread or catch AIDS.

Although there is no cure for HIV there are extremely effective medications which mean that if detected early, people with HIV live long, healthy lives and will not develop HIV.

How is HIV transmitted?

HIV is not spread easily like coughs and cold viruses; it doesn’t travel through the air. Instead, HIV is found in blood and bodily fluids such as semen, breast milk, vaginal discharge and blood during a period and the lining of the anus. Sweat, urine and saliva do not contain enough virus to cause infection – so you can’t pass on or catch HIV from kissing, sneezing, coughing or sharing cutlery or toilets.

In general, in the UK most cases are caused by sexual contact – having sex with an infected person without a condom, be it vaginal, anal or oral sex (though the risks of transmission from oral sex is lower). You may be at a higher risk of becoming infected with HIV if:

• You have a partner with HIV, or your partner is from an area which has high HIV
• You are a man who has unprotected sex with men, or a woman who has unprotected sex with men who have sex with men
• You have chemsex
• You have a history of STIs
• You share sex toys with someone infected with HIV
• You are an intravenous drug user or have sex with an intravenous drug user
• You have multiple sexual partners
• You have been a victim of sexual assault

You may also be at a higher risk if you have a received a blood product such as a transfusion in a country without HIV screening. Babies can be at risk if the mother had untreated HIV during pregnancy.

How do I know if I have HIV?

Get tested

About 4 out of 5 people with HIV will develop a flu like illness, generally 2 – 6 weeks after the infection. HIV Symptoms include a fever, aches and pains, feeling tired, a sore throat, rash, and swollen glands for 1-2 weeks. But remember these symptoms are common for lots of viral infections, having them doesn’t automatically mean that you have HIV.

There may not then be any symptoms for years. But during this time, the virus continues to damage the immune system. Eventually, perhaps up to ten years later, when the immune system is damaged AIDS develops. Symptoms can include night sweats, weight loss, diarrhoea, recurrent, frequent, and potentially severe infections, and other serious illnesses.

How is HIV diagnosed?

A HIV test is used to diagnose HIV.

HIV tests are available from sexual health clinics, family planning clinics, from clinics run by charities like the Terence Higgins Trust, from some GP surgeries, antenatal clinics and some drug services. They are available free on the NHS. There are also home tests available, some for free and others privately. For example, Sexual Health London offers self STI checking for most boroughs in London and Freestesting HIV offers home HIV and potentially syphilis testing depending on your area. Alternatively, there are private home testing kits available.

What are the treatments for HIV?

If you think you have been exposed to HIV, seek medical help as there are anti-HIV medicines which can stop you becoming infected if taken within 72 hours of being exposed to the virus.

If you are HIV positive you will be offered antiretroviral medication which stops the virus replicating in the body. You will be offered regular blood tests to monitor the amount of HIV in your blood to see how well the treatment is working. Other support such as counselling is available.

Can HIV be prevented?

Yes!

Safe sex with condoms is the most effective way of preventing transmission of HIV. Lubricants also reduce the risk of vaginal or anal tears or of condoms tearing, but only water-based lubricants are safe to be used with condoms. Oil based lubricants weaken condoms so should be avoided.

Avoid sharing needles, syringes, or other injecting equipment if you inject drugs.

If you do have HIV, you will be offered antiretroviral medication with the aim of reducing the viral load to undetectable levels, where levels are so low, they can’t be seen on the test. If your viral load is undetectable for six months or more, you cannot transmit the virus – undetectable = untransmissible (U=U). So, you could consider this as treatment and prevention.

Pre-exposure prophylaxis (PrEP) is a medication used to reduce your risk of getting the virus if you are at high risk and are HIV negative, it is available from sexual health clinics.

The final word:

HIV can be treated effectively, so that AIDS does not develop, and you cannot transmit the infection to others. Get tested!